Obama administration officials say that trimming payments to nursing homes and other providers would substantially reduce future Medicare and Medicaid outlays. But officials are insisting that Republicans accept tax hikes as a condition for such spending cuts.

House leaders are keeping all options on the table on a healthcare reform vote as the Aug. 7 congressional recess date nears. Among the possibilities is their bypassing the Energy and Commerce Committee and sending their healthcare reform package straight to a floor vote.

A draft of House healthcare reform legislation is set to slice $44.9 billion in nursing home funding over the next decade, according to a group of senior care advocates. The coalition sent a letter to powerful House leaders urging them to reconsider such cuts.